(CNN) -- It used to be called stomach stapling, but today there are several variations on the gastric bypass. Doctors have improved this surgery for the obese dramatically over the past few years. But it is not without risks.
Since the late 1970s, Los Angeles Dr. Mathias Fobi has operated on more than 6,000 obese patients who were not successful with diet or exercise and whose excess weight put them at high risk for heart disease, diabetes and stroke.
In recent years, many performers have had the procedure, including Roseanne Barr and Jo Marie Payton, who played Harriette Winslow on the TV series "Family Matters."
"Twenty years ago, we only operated on people 400 and 500 pounds because the surgery was not widely accepted. Nowadays we're operating on patients 200 pounds and above," Fobi said.
Five years after the surgery, 95 percent of his patients maintain a 40 percent weight loss, he said.
Though there are many variations to the gastric bypass, all the procedures reduce the size of the stomach so that less food can be consumed at one time. The new mini-stomach holds only an ounce of food instead of 50 or 80 ounces.
The operation and follow-up can be expensive, up to $20,000, and insurance does not always cover it.
There are also risks. Nationally, about one in every 100 patients dies during the operation, according to the American Society for Bariatric Surgery. Also, surgery survivors must take dietary supplements for the rest of their lives.
"In gastric bypass, you bypass part of the stomach and where the juice comes from the liver and pancreas, and therefore, some vitamins are not absorbed," said Fobi.
Alan Steadham of the International Size Acceptance Association says there is an alternative to bariatric surgery: simply accepting yourself no matter what the scale says.
"With size acceptance, you learn that you can function as a human being at whatever size you happen to be," said Steadham.
Taken from CNN.com